The CORE-OM is a reliable and valid instrument with good sensitivity to change. It is acceptable in a wide range of practice settings.

To complement the evidence-based practice paradigm, the authors argued for a core outcome measure to provide practice-based evidence for the psychological therapies. Utility requires instruments that are acceptable scientifically, as well as to service users, and a coordinated implementation of the measure at a national level. The development of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is summarized. Data are presented across 39 secondary-care services (n = 2,710) and within an intensively evaluated single service (n = 1,455). Results suggest that the CORE-OM is a valid and reliable measure for multiple settings and is acceptable to users and clinicians as well as policy makers. Baseline data levels of patient presenting problem severity, including risk, are reported in addition to outcome benchmarks that use the concept of reliable and clinically significant change. Basic quality improvement in outcomes for a single service is considered.

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This study examined rates of improvement in psychotherapy as a function of the number of sessions attended. The clients (N=1,868; 73.1% female; 92.4% White; average age=40), who were seen for a variety of problems in routine primary care mental health practices, attended 1 to 12 sessions, had planned endings, and completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended. Among clients who began treatment above the CORE-OM clinical cutoff (n=1,472), the RCSI rate ranged from 88% for clients who attended 1 session down to 62% for clients who attended 12 sessions (r=-.91). Previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.

The 34‐item Body Shape Questionnaire (BSQ) has demonstrated sound psychometric properties in all samples reported to date (including this study). However, the unidimensional nature of the 34 items suggests that the BSQ may be unnecessarily long for use in studies when body disparagement is not the main focus of investigation. This study of 342 adult women presents two 16‐item “alternate forms” of the BSQ which showed equivalent means and excellent internal consistency in both derivation and replication samples. Two 8‐item scales were also derived. The 34‐, 16‐, and 8‐/tem versions showed equivalent convergent and discriminant validation against the Eating Attitudes Test (EAT)‐26 and other parameters. We suggest that use of these 16‐item versions may be more efficient than the original BSQ where body disparagement is not the sole focus of a study, or where a repeated measures design is employed. Furthermore, the 8‐item versions are sufficiently robust to be used as “alternate forms” where speed of completion and economy are of the essence. © 1993 by John Wiley & Sons, Inc.

A series of editorials in this Journal have argued that psychiatry is in the midst of a crisis. The various solutions proposed would all involve a strengthening of psychiatry's identity as essentially 'applied neuroscience'. Although not discounting the importance of the brain sciences and psychopharmacology, we argue that psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.

Background: There is a need for a generic, short, and easy‐to‐use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE‐10 in response to this need. Method: Items were drawn from the CORE‐OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE‐OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow‐up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE‐10 in its standalone format. Results: The internal reliability (alpha) of the CORE‐10 was .90 and the score for the CORE‐10 correlated with the CORE‐OM at .94 in a clinical sample and .92 in a non‐clinical sample. The clinical cut‐off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut‐off score for the CORE‐10 was 13 and yielded sensitivity and specificity values of .92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion: The CORE‐10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings.

The authors report a literature review of impulsivity in the substance abuse disorders, eating disorders, classical disorders of impulse control, self-harm and personality disorders. They suggest that within each of these clinic populations there is a significant number of patients who have a very poor prognosis and are characterised not just by the specific presenting symptom but by multiple impulsive behaviours. It is suggested that this group, who place very large demands both on the psychiatric and emergency services, form a unitary 'multi-impulsive personality' group and that they would repay detailed research which cuts across the boundaries of the specialist services.